Symptom Ker and Ortner with cholecystitis. Manifestation of symptoms and location of their localization
The causes of the appearance of cholecystitis in humans can beto act various chronic diseases, or changes in the structure of certain vessels of the biliary tract. It can also develop due to stomach diseases (only those that are accompanied by discoloration). The main reference point in the definition of the disease is Kehra's symptom.
Common symptoms of cholecystitis
Depending on the localization of inflammation or changes in the structure of blood vessels and bile ducts, there are many symptoms of the disease:
- dull pain in the right hypochondrium, which extends upwards - to the area of the right scapula, collarbone and shoulder; with the development of the disease, the pain becomes more acute and intense;
- nausea and vomiting, which is provoked by pain;
- the taste of bitterness in the mouth;
- presence of bile impurities in the emetic masses;
- the tongue is coated and overdried;
- possibly fever and chills;
- in the case of disease progression, tachycardia and an increase in blood pressure are detected;
- if the lumen of the bile ducts is blocked (if there are stones in it), then the person has pronounced jaundice;
- pain in palpation in the right hypochondrium.
In addition to these, the main featuredisease is a symptom of Kera. It is expressed in pain when palpated in the area of the diseased organ. With the development of the disease, the pain has an increasing character and spreads less localized.
Specific symptoms of cholecystitis
To particular manifestations of the disease aresymptoms of Ker and Ortner. Further examination occurs after confirmation of the presence of these manifestations. To find the first symptom, it is enough to conduct a deep palpation of the right hypochondrium, in this case the patient will have a sharp sharp pain.
The symptom of Ortner is detected bytapping of the costal arch on the right side with the palm rim. In the presence of the disease, all manipulations will be accompanied by painful sensations of varying degrees, depending on how badly the disease has developed and what is the age and general health of the person.
In addition, they also distinguish:
- Symptom Obraztsova - when a person inhales during palpation and pain intensifies;
- a symptom of Murphy - the inability to breathe with deep palpation in the right hypochondrium;
- a symptom of Mussi-Georgievsky - when palpation of the sternocleidomastoid muscle (in the region of its legs), the patient exhibits painful sensations.
At the laboratory analysis of a blood neutrophilia, a leukocytosis and a lymphopenia can be found out.
When symptoms appear
Using the Kehr symptom, it is possible to determine the presence of an effeminate cholecystitis. In the presence of stones in the gallbladder or biliary tract distinguish other symptomatic manifestations.
Symptom Kera with acute cholecystitis consists in the appearance of soreness in the gallbladder area when carrying out deep palpation in the location of the diseased organ.
Acute cholecystitis can be differentiated with ulcerduodenum or stomach, as well as with acute pancreatitis, appendicitis or renal colic. In order not to confuse these diseases, it is important to be able to distinguish them.
With peptic ulcers, the pain arises abruptly, tothe same it is sharp enough, whereas with cholecystitis in the region of the liver the pain is dull and with time increases slightly. There is also a temperature around 38 degrees and vomiting with bile.
In acute pancreatitis, the pain is localized in the left hypochondrium, and can also be accompanied by continuous vomiting.
Acute appendicitis does not have pain in its symptoms, irradiating to the shoulder and shoulder blade, and also does not appear as vomiting. With appendicitis, the patient lacks the symptom Kera and Mussi.
With renal colic there is no increase in temperature and the presence of leukocytosis in the blood. The pain is localized mainly in the lumbar region and extends to the hips and pelvic organs.
Treatment of cholecystitis
Treatment of cholecystitis should begin beforehospitalization of the patient. Intravenous drugs are introduced that help reduce painful sensations (most often the "No-shpy" injection solution is used), and lowering the pressure in the gall bladder, due to improved bile flow to the small intestine.
Kehr's symptom in cholecystitis is the cause of immediate hospitalization of the patient followed by prompt or conservative intervention by medical personnel.
The timely attention to the presence of the described symptoms and the ability to distinguish them from differential diseases increases the chance for a quick recovery without surgery.